WILMINGTON, Del.  The state of Delaware missed several red-flag warnings that could have led to an earlier arrest of pediatrician Earl Bradley, accused of raping or abusing more than 103 children since 1998, a four-month analysis of the case concluded Tuesday.

Widener University Law School Dean Linda Ammons, appointed in January by Democratic Gov. Jack Markell to conduct an independent review of the case, said authorities had known since the mid-1990s that there might be issues with Bradley. However, she added, authorities didn't talk to one another in ways that would have brought the situation to light.

Bradley, 57, has pleaded not guilty to all charges outlined in two indictments — a total of 529 counts.

The 63-page report addresses mistakes made in the case dating to 1994, when — after being investigated in Philadelphia for allegedly touching a child improperly — Bradley moved his practice to the Delaware seashore town of Lewes and took a job at Beebe Medical Center.

"A tragedy of this magnitude may have been pre-empted if the individuals directly involved had been more focused and alert, less willing to give Bradley the benefit of the doubt, and if they had scrupulously followed the law," Ammons wrote.

"Systems were in place to catch a perpetrator, but they were either not properly accessed, or when called upon, human and mechanical error prevented the appropriate actions from being taken."

Among the findings:

•When a judge would not let state police search Bradley's office in December 2008, the judge told investigators he would sign a warrant for the pediatrician's arrest, the report says. Prosecutors decided they didn't have enough evidence to prove he was conducting inappropriate vaginal exams.

•During the year-long period from the judge's denial until Bradley's arrest in December 2009, the pediatrician allegedly raped or sexually abused nearly 50 young girls, a review of indictments shows.

•Delaware's Board of Medical Practice, which issued him a license that April, discussed that complaint with Pennsylvania authorities but decided to take no action.

The report also questioned why nobody in law enforcement or the medical community contacted Delaware's medical board about Bradley despite several complaints and police probes of his actions. No one reported Bradley to the medical board despite a Delaware law that requires police, prosecutors, doctors and nurses who "reasonably believe" a doctor is guilty of misconduct or unfit to practice medicine to file a written complaint with the board, the report said.

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